OPERATOR’S GUIDE LEAD CO2 31 Hg 17RR m m Sp02 % SIZE HR LEAD CHARGE x1.
An issue or revision date for this manual is shown on the front cover. If more than three years have elapsed since this date, contact ZOLL Medical Corporation to determine if additional product information updates are available. ZOLL, M Series, CPR-D•padz, and stat•padz are registered trademarks of ZOLL Medical Corporation. ZOLL Data Control Software, and Real CPR Help are trademarks of ZOLL Medical Corporation. 12SL and Catalyst MUSE are trademarks of GE Medical Systems.
Table of Contents Section 1 General Information Product Description ............................................................................................................ 1-1 How to Use This Manual..................................................................................................... 1-2 Manual Updates.................................................................................................................. 1-2 Unpacking ..........................................................
Section 2 Operating Controls and Indicators Code Markers ..................................................................................................................... 2-3 Summary Report................................................................................................................. 2-4 Summary Report Formats .......................................................................................... 2-4 Defibrillation Format ...........................................................
CPR Compressions Indicator ............................................................................................. 7-2 CPR Idle Time Display........................................................................................................ 7-2 CPR Metronome ................................................................................................................. 7-2 Section 8 Non-Invasive Temporary Pacing (Pacer Version Only) Non-invasive Temporary Pacing ...............................
Manual Defibrillator Testing .............................................................................................. 10-2 1. Power-Up Sequence Check ................................................................................. 10-2 2. Delivered Energy and Shock Buttons ................................................................... 10-2 3. Energy Delivery Test (Paddles/MFE Pads) .......................................................... 10-3 4. Pacer Operation (Pacer Version Only) ...........
Appendix C Medical Report Capability PCMCIA Data Card.............................................................................................................C-1 Installing the PCMCIA Data Card .......................................................................................C-1 Erasing A Memory Card .....................................................................................................C-1 Warning Messages .............................................................................
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SECTION 1 GENERAL INFORMATION NOTE: Your M Series may or may not contain all the features listed in this manual, depending on your particular configuration. Product Description The ZOLL® M Series® products combine a defibrillator, ECG display, advanced monitoring capabilities, and Noninvasive Transcutaneous Pacing (NTP) with communication, data printing and recording capabilities in a single lightweight portable instrument.
M SERIES OPERATOR ’S GUIDE Some M Series products are intended for use in the pre-hospital emergency medical care setting, indoors and outdoors, including first response vehicles, fire vehicles, basic and advanced level ambulances as well as by both Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) staff in hospitals under protocol control.
General Information * These accessories are considered safety-relevant components Symbols Used on the Equipment Any or all of the following symbols may be used in this manual or on this equipment: Type B patient connection Type BF patient connection Type CF patient connection Defibrillation protected Type BF patient connection Defibrillation protected Type CF patient connection Attention Refer to manual for more information Fusible Link Protective (earth) ground terminal DANGER High Voltage presen
M SERIES OPERATOR ’S GUIDE Defibrillator Function The M Series products contain a DC defibrillator capable of delivering up to 360 joules of energy. It may be used in synchronized mode to perform synchronized cardioversion by using the R-wave of the patient’s ECG as a timing reference. The unit uses paddles or disposable, pre-gelled, MFE Pads for defibrillation.
General Information External Pacemaker (Pacer Version Only) As a standby when standstill or bradycardia might be expected: Non-invasive Transcutaneous Pacing (NTP) is an established and proven technique. This therapy is easily and rapidly applied in both emergency and nonemergency situations when temporary cardiac stimulation is indicated. Some M Series products may contain an optional demand pacemaker consisting of a pulse generator and ECG sensing circuitry.
M SERIES OPERATOR ’S GUIDE This reddening should substantially lessen within 72 hours. The pacer version of the M Series will also pace using ZOLL MFE Pads. There have been reports of burns under the anterior electrode when pacing adult patients with severely restricted blood flow to the skin. Prolonged pacing should be avoided in these cases and periodic inspection of the skin is advised. Energy Select, Charge, and Shock controls are located on the paddles and front panel.
General Information External Battery Charger External battery charging and capacity evaluation is performed with the ZOLL Base PowerCharger4x4. Up to four battery packs can be charged simultaneously and testing is automatic. See the appropriate ZOLL battery charger Operator's Guide and Battery Management Program for more detailed information on the specifications, use and management of ZOLL battery packs.
M SERIES OPERATOR ’S GUIDE Safety Considerations The M Series products are high energy devices capable of delivering up to 360 joules. To completely deactivate the device, you must turn the SELECTOR SWITCH to the OFF position.
General Information WARNINGS (Continued) • • • • • The ECG out signal is delayed by up to 25 ms. This delay must be considered when the ECG out signal is used as an input to other devices requiring R-wave synchronization. The M Series device may not perform to specifications when stored at the upper or lower extreme limits of storage temperature and immediately put into use. Avoid using the M Series adjacent to, or stacked on other equipment.
M SERIES OPERATOR ’S GUIDE WARNINGS (Continued) • • To avoid electrosurgery burns at monitoring sites, ensure proper connection of the electrosurgery return circuit so that the return paths cannot be made through monitoring electrodes or probes. Prolonged pacing (in excess of 30 minutes), particularly in neonates or adults with severely restricted blood flow, may cause burns. Periodic inspection of the underlying skin is recommended. • Check leakage levels prior to use.
General Information FDA Regulations Warranty (U.S. Only) Tracking Requirements (a) ZOLL Medical Corporation warrants to the original equipment purchaser that beginning on the date of installation, or thirty (30) days after the date of shipment from ZOLL Medical Corporation's facility, whichever first occurs, the equipment (other than accessories and electrodes) will be free from defects in material and workmanship under normal use and service for the period of one (1) year.
M SERIES OPERATOR ’S GUIDE Software License Service Note: Read this Operator’s Manual and License agreement carefully before operating any of the M Series products. The device does not require periodic recalibration or adjustment. Appropriately trained and qualified personnel should, however, perform periodic tests of the device to verify proper operation. (See General Maintenance Section).
General Information Defibrillator Waveform Information General The following defibrillation waveforms are produced when the device is discharged into 25, 50 and 100 ohm loads at maximum energy. Each major vertical division equals 1000 volts; each major horizontal division equals 2 milliseconds.
M SERIES OPERATOR ’S GUIDE ECG Analysis Algorithm Accuracy Sensitivity, specificity, false positive rate and positive predictivity are expressions of the accuracy of an ECG analysis system when compared with clinicians or experts. The specifics of computations are detailed below. The accompanying data details the accuracy of the algorithm as tested by independent investigators. The Algorithm: • Divides the ECG rhythm into three 3-second segments. • Filters and measures noise, artifact, and baseline wander.
SECTION 2 OPERATING CONTROLS AND INDICATORS 7 8 910 23 3 LEAD CO2 31 Hg 17RR m m Sp02 % SIZE LEAD CHARGE x1.5 72 ECG 100 HR PADS SIZE 2 3 ANALYZE 4 ENERGY SELECT ALARM SUSPEND 2 ECG RECORDER 1 DEFIB MONITOR CO2 1 OFF 22 PACER Param Wave 2 PACER OUTPUT mA Alarms 5 SHOCK PACER RATE ppm 4:1 21 SUMMARY CHARGER ON CODE MARKER 20 19 RELEASE 11 12 13 14 15 16 17 6 18 1. SELECTOR SWITCH 4.
M SERIES OPERATOR ’S GUIDE 5. ANALYZE standard monitoring bandwidth when the RECORDER button is released. The ANALYZE button initiates ECG analysis to identify shockable rhythms. 11. BEEPER VOLUME (ECG) 6. SOFTKEYS This button allows for manual adjustment of the QRS beeper tone from maximum volume to inaudible. (The heart rate alarm and charge ready volumes are not adjustable.) Press this button to display a menu for adjusting the volume using softkeys.
Operating Controls and Indicators 18. PC Card Modem Slot (12-Lead Option Only) PEDI Button Holds the modem card for transmitting 12-Lead ECG information to remote locations via landline or cellular phone. See the 12-Lead ECG Monitoring insert (part number 9650-0215-01) for more information. Adult Electrode (Shoe) Note: The modem slot is covered by a plastic bezel. 19. PACER OUTPUT mA (Pacer Version Only) When pacing is selected, this control sets the amount of current delivered to the MFE Pads.
M SERIES OPERATOR ’S GUIDE Summary Report Summary Report allows you to store and later retrieve important ECG and device event information. The unit’s internal memory automatically records defibrillation and cardioversion segments, PACER mode (Pacer version only), heart rate alarm and ECG segments upon activation of the stripchart recorder. Associated event information including device control settings, patient ECG, time and date are recorded as well.
Operating Controls and Indicators Pacer Format (Pacer version only) Summary Report records 6 seconds of pre-pacer patient ECG data. Also recorded are the ECG lead, ECG size, patient's heart rate, time and date. NAME 15:19:50 10 MAY 93 PRE-PACE ECG ECG LEAD ECG SIZE HEART RATE II 2 38 After establishing a paced rhythm, turning the recorder on briefly will record the paced rhythm for later reports. If async pace is active, the annotation “ASYNC PACE” is also recorded.
M SERIES OPERATOR ’S GUIDE Analyze Format The summary report records 6 seconds of pre analysis ECG and 9 seconds of ECG recorded during the ECG analysis interval with the annotation “SHOCK ADVISED” or “NO SHOCK ADVISED”. AED units will additionally include shock count and AED mode annotations.
Operating Controls and Indicators Printing a Report Adding Patient Name and ID# to a Report To print the stored information, press the SUMMARY button below the screen display. Then press the corresponding softkey to print configuration settings, print chart, or print log. CHARGER ON SUMMARY CODE MARKER The recorder will print all events currently in memory in chronological order. If the stripchart recorder is on or the defibrillator is charged, summary report printing is disabled.
M SERIES OPERATOR ’S GUIDE To print an incident log: 1. Press the SUMMARY button. 2. Press the Print Log softkey. The M Series unit prints incident log. Erasing Summary Report Memory To erase all stored information, press and hold the SUMMARY button for approximately 4 seconds. Then press the corresponding softkey to erase summary, erase trend, or erase all event reports. An “ERASING REPORT” message will appear on the display.
SECTION 3 MANUAL DEFIBRILLATION Paddles are a defibrillation protected Type BF patient connection. ECG leads are a defibrillation protected Type CF patient connection. Emergency Defibrillation Procedure with Paddles WARNING • To avoid risk of electrical shock, do not allow electrolyte gel to accumulate on hands or • paddle handles. When defibrillating with paddles use your thumbs to operate the SHOCK buttons in order to avoid inadvertent operator shock.
M SERIES OPERATOR ’S GUIDE CHARGE 2 3 connection of standard ECG monitoring electrodes. The unit automatically pre-selects “PADDLES” when it is initially turned on and paddles are connected to the Multi-Function cable. ANALYZE SHOCK ENERGY SELECT or If an ECG cable and ECG electrodes are in use, press the LEAD button to select the desired ECG lead configuration - I, II, III or PADDLES (also aVR, aVF, aVL and V if the unit has been so configured).
Manual Defibrillation Using your thumbs, simultaneously press and hold both SHOCK buttons (one on each paddle) until energy is delivered to the patient. Once energy is delivered, the display will simultaneously show “XXXJ DELIVERED” and “DEFIB XXXJ SEL.” After approximately 5 seconds the “XXXJ DELIVERED” message will disappear and the “DEFIB XXXJ SEL” message remains to indicate the selected energy level. CAUTION • Only use thumbs to depress the SHOCK buttons.
M SERIES OPERATOR ’S GUIDE Emergency Defibrillation Procedure with MFE Pads Paddles are a defibrillation protected Type BF patient connection.
Manual Defibrillation Energy Select Observe the display and verify the selected energy is appropriate. To change the energy setting use either pair of up/down arrow buttons. One pair is located on the front panel of the unit, the other pair is located on the sternum paddle. The selected energy level will be shown as “DEFIB XXXJ SEL.” on the display.
M SERIES OPERATOR ’S GUIDE Open Chest Defibrillation with Internal Handles and Electrodes ZOLL Autoclavable Internal Handles are designed for use with a manually operated ZOLL defibrillator and internal defibrillation electrodes to defibrillate the heart during open chest surgical procedures. When used with a ZOLL defibrillator equipped with an advisory or ECG analysis feature, the ZOLL Autoclavable Internal Handles allow the defibrillator to operate only as a manual device.
SECTION 4 ADVISORY DEFIBRILLATION When Multi-function Electrode (MFE) Pads are used, the patient connection is considered to be defibrillation protected Type BF. Advisory Defibrillation Ensure that all MFE Pads are making good contact with the patient’s skin and are not covering any part of the ECG electrodes. WARNING • Do not use the unit’s Advisory function on patients under 8 years of age.
M SERIES OPERATOR ’S GUIDE 1 Select DEFIB 1 MONITOR ECG DEFIB ANALYZING ECG OFF PACER 00:01 The unit displays “DEFIB 200J SEL” on the monitor until the ANALYZE button is depressed by the operator. Param Wave 2 ID# Alarms Sync On/Off Once the analysis is completed, the unit indicates whether or not a shock is advised. When a non-shockable rhythm is detected the message “NO SHOCK ADV.” will be displayed. ECG NO SHOCK ADV. DEFIB 200J SEL. ECG DEFIB 200J SEL.
Advisory Defibrillation 3 Press SHOCK Advisory Function Messages SELECT DEFIB MODE WARNING • Warn all persons in attendance of the patient to STAND CLEAR prior to defibrillator discharge. • Do not touch the bed, patient, or any equipment connected to the patient during defibrillation. A severe shock can result. Do not allow exposed portions of the patient's body to come in contact with metal objects, such as a bed frame, as unwanted pathways for defibrillation current may result.
M SERIES OPERATOR ’S GUIDE CHECK PATIENT The unit detects a shockable rhythm during continuous background ECG analysis without initiating an analysis (i.e., Smart Alarms™). The prompt is given when the heart rate alarms are enabled and the unit detects a shockable rhythm or if the rhythm goes from nonshockable to shockable. The screen message persists as long as a shockable rhythm is being detected. Press the ANALYZE button to begin ECG analysis.
SECTION 5 AUTOMATED EXTERNAL DEFIBRILLATOR (AED) OPERATION When Multi-function Electrode (MFE) Pads are used, the patient connection is considered to be defibrillation protected Type BF. Introduction WARNING • Do not use the unit’s Advisory function on patients under 8 years of age. This section describes the recommended method of operation. If your local protocol requires a different procedure, follow that protocol.
M SERIES OPERATOR ’S GUIDE making good contact with the patient or if a short circuit exists between the MFE pads. Energy Select MFE Pad Application WARNING • Poor adherence and/or air under the MFE Pads can lead to the possibility of arcing and skin burns. 1. Apply one edge of the pad securely to the patient. 2. “Roll” the pad smoothly from that edge to the other being careful not to trap any air pockets between the gel and skin.
Automated External Defibrillator (AED) Operation After the energy is delivered to the patient, the display returns to XXX J SEL. SHOCKS: 1, indicating the number of shocks administered to the patient. shockable the unit will display a “SHOCK ADVISED” message. ECG SHOCK ADVISED CHARGING 76J 00:01 Manual Mode NIBP ID# The defibrillator will begin charging automatically to the pre-configured energy setting and display a “CHARGING” message.
M SERIES OPERATOR ’S GUIDE announced. Pressing and holding the SHOCK button on the front panel delivers the shock to the patient. The lower portion of the display indicates the energy levels selected, the number of shocks delivered during the incident, the elapsed time (if enabled), and softkey function labels. Additional unit status information is also displayed on the monitor.
Automated External Defibrillator (AED) Operation AED Manual Mode Operation Press the Manual Mode softkey on the front panel of the unit to enter the manual mode of operation. Refer to the “Manual Defibrillation”, “Advisory Defibrillation”, “Pacing”, and “ECG Monitoring” sections for the appropriate operation in manual mode. AED Voice Prompts The following is a list of the AED voice prompts: ECG 200J SEL.
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SECTION 6 SYNCHRONIZED CARDIOVERSION Paddles are a defibrillation protected Type BF patient connection. ECG leads are a defibrillation protected Type CF patient connection. WARNING • Synchronized cardioversion should only be attempted by skilled personnel trained in ACLS • (Advanced Cardiac Life Support) and familiar with equipment operation. The precise cardiac arrhythmia must be determined before attempting defibrillation.
M SERIES OPERATOR ’S GUIDE Turn Selector Switch to MONITOR 1 MONITOR ECG DEFIB SYNC 200J SEL. OFF 00:01 PACER Param Press the LEAD button to select the desired ECG lead. The lead selected is displayed at the top of the screen. Synchronized discharge with “PADDLES” as ECG source is discouraged since artifacts induced by moving the paddles may resemble an R-wave and trigger defibrillator discharge at the wrong time.
Synchronized Cardioversion 3 Deliver SHOCK WARNING • Warn all persons in attendance of the patient to STAND • CLEAR prior to defibrillator discharge. Verify that no one is in contact with the patient, monitoring cable or leads, bed rails, or any other potential current pathways. Verify that the ECG waveform is stable and that a marker only appears with each R-wave.
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SECTION 7 CPR ASSISTANCE The CPR sensor is defibrillation-proof Type BF equipment. WARNING • • The CPR Assist function is not intended for use on patients under 8 years of age. The CPRD-to-MFC connector is intended for use with the M Series, or other ZOLL defibrillators where indicated. When used with CPR-D•padz, the M Series unit can provide rescuers with feedback about the quality of CPR they are delivering to their patients.
M SERIES OPERATOR ’S GUIDE CPR Compressions Indicator compressions have been delivered for more than 20 minutes, dashes (---) will be displayed in this time field. This rectangular bar shaped figure provides a quick, overall indicator of how well the rescuer’s combined rate and depth of chest compressions match the AHA/ERC recommendations for adult CPR. CPR Idle Time Before chest compressions begin (and after each shock), the Chest Compression Indicator is displayed as a hollow outline.
SECTION 8 NON-INVASIVE TEMPORARY PACING (PACER VERSION ONLY) Paddles are a defibrillation protected Type BF patient connection. ECG leads are a defibrillation protected Type CF patient connection. WARNING • To avoid risk of electrical shock, do not touch the gelled area of the MFE Pads while pacing. • MFE Pads should be replaced after 8 hours of continuous pacing (2 hours for Radiolucent stat•padz) to ensure maximum patient benefit.
M SERIES OPERATOR ’S GUIDE 3 Set Pacer Rate Electrical capture is determined by the presence of a widened QRS complex, the loss of any underlying intrinsic rhythm, and the appearance of an extended, and sometimes enlarged, T-wave. Set PACER RATE to a value 10-20 ppm higher than patient’s intrinsic rate. If no intrinsic rate exists, use 100 ppm. The pacer rate will increment or decrement by a value of 2 ppm on the display when the knob is turned.
Non-Invasive Temporary Pacing (Pacer Version Only) 6 Determining Optimum Threshold Special Pacing Applications The ideal output current is the lowest value that will maintain capture. This is usually about 10% above threshold. Typical threshold currents are between 40 and 80 mA. Location of the MFE Pads will affect the current required to obtain ventricular capture.
M SERIES OPERATOR ’S GUIDE Asynchronous Pacing If ECG electrodes are not available or there is some circumstance that prevents or interferes with the surface ECG, it may be necessary to operate the pacemaker asynchronously. Asynchronous pacing should only be performed in emergency situations when there are no other alternatives. To pace asynchronously: Press the “Async Pacing On/Off” Softkey. The display will show “ASYNC PACE” to indicate that asynchronous pacing has been activated.
SECTION 9 ECG MONITORING ECG leads are a defibrillation protected Type CF patient connection. Introduction The M Series products can be used for either short-term or long-term ECG monitoring. M Series products have built-in protection circuitry to prevent damage to their ECG monitoring circuits during defibrillation attempts. Monitoring electrodes may become polarized during defibrillator discharge, causing the ECG waveform to briefly go off screen.
M SERIES OPERATOR ’S GUIDE Attach Monitoring Electrodes Peel the protective backing from the ECG electrode. Be careful to keep adhesive surface free of electrolyte gel. WARNING • Apply the ECG electrodes firmly to the patient’s skin, pressing around the entire perimeter of the electrodes. Attach snap-on leads and check for good contact between the electrode and the lead termination. Plug the patient cable connector into the ECG input connector (located on the rear panel of the instrument).
ECG Monitoring Alarms Alarm Function Setting Alarm Limits Unless configured otherwise, heart rate alarms are preset at 30 bpm (bradycardia) and 150 bpm (tachycardia). Refer to the Alarms Section of the Physiological Monitoring Parameter Insert(s) for further details specific to those parameters. (See the M Series Configuration Guidefor details on setting power-up alarm limits.) In order to set alarms the following sequence is used: 1.
M SERIES OPERATOR ’S GUIDE combine monitoring and defibrillation with heart rate alarms enabled, use MFE Pads. ALARM SUSPEND button. The M Series unit will perform in the same way that we describe above for the first alarm. Recorder Operation Silencing Alarm Tones To silence the alarm tone, press and hold down the ALARM SUSPEND button for between 1 and 3 seconds (hold down button for at least one second, but less than 3 seconds).
ECG Monitoring messages are only displayed the first time the augmented or V-leads are selected. They are not redisplayed as the user cycles through the Lead selection. stored whenever a parameter alarms or an NIBP measurement is taken. Note that these additional records will decrease the overall number of one minute trend records that can be stored in the unit’s memory.
M SERIES OPERATOR ’S GUIDE The most recently recorded values are indicated by highlighting the time stamp associated with the trend data. If no time record is highlighted, older data is being displayed. To view the newest values of recorded data, press the Newer softkey until the highlighted time displays. When viewing the newest data, the display automatically updates as each new trend record is recorded. To view older values of recorded data, press the Older softkey until the desired data displays.
SECTION 10 GENERAL MAINTENANCE Periodic Testing Cleaning Resuscitation equipment must be maintained to be ready for immediate use. The following operational checks should be performed at the beginning of every shift to ensure proper equipment operation and patient safety. The M Series products and their accessories are chemically resistant to most common cleaning solutions and non-caustic detergents.
M SERIES OPERATOR ’S GUIDE Semi-Automatic Defibrillator Testing Manual Defibrillator Testing 1. Power-Up Sequence Check 1. Power-Up Sequence Check Connect the patient end of the multifunction cable to the defibrillator test connector.
General Maintenance Multi-Function Cable Setup • Verify that the pacing stimulus markers ( • The Multi-Function cable should be plugged into the unit. Make sure the Multi-Function cable is not plugged into its test connector. Switch unit to DEFIB and set energy to 30 joules. • • • The messages “CHECK PADS” and “POOR PAD ) occur approximately every 10 small divisions (2 large divisions, 1 cm).
M SERIES OPERATOR ’S GUIDE Changing Paper Press down and pull the paper tray drawer where the “RELEASE” label is located. The drawer slides open. Check for adequate paper supply. If paper supply is low, remove paper in the tray. Place a new pad of thermal paper in the drawer with the paper coming off the top of the pad and the grid facing up. Pull enough paper off the pad so that the paper extends out of the strip recorder when the paper compartment drawer is closed.
General Maintenance Error Message Description/Corrective Action NO CARRIER The unit determined that the line is broken. Correct the line break and retry. HANG UP The unit received a hang up indication from the selected NIST location. Retry. MODEM DIAL ERROR The modem could not dial the phone number. Ensure that the modem card is properly connected. Ensure that the user-selected dial prefix (set in the System Configuration or System Utilities mode) is correct. Retry.
Operator’s Shift Checklist for M Series Products (Manual) Recommended checks and procedures to be performed at Date ______________________________________________ the start of each shift. For more detailed information, see Location ____________________________________________ the M Series Operator’s Guide. Unit Serial Number ___________________________________ 1st Shift 1. Condition 2nd Shift 3rd Shift Remarks Unit clean, no spills, clear of objects on top, case intact 2.
Operator’s Shift Checklist for M Series Products (Semi-Automatic) Recommended checks and procedures to be performed at Date ______________________________________________ the start of each shift. For more detailed information, see Location ____________________________________________ the M Series Operator’s Guide. Unit Serial Number ___________________________________ 1st Shift 1. Condition 2nd Shift 3rd Shift Remarks Unit clean, no spills, clear of objects on top, case intact 2.
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SECTION 11 BATTERY MANAGEMENT Battery Care This message and beeping will persist until just before device shutdown when the unit beeps twice and the “REPLACE BATTERY” message appears for approximately 20 seconds. WARNING • Regular use of partially charged battery packs without fully recharging between uses will result in permanently reduced capacity and early battery pack failure.
M SERIES OPERATOR ’S GUIDE prior to replacing the battery. When operation of the unit is resumed subsequent to battery replacement, the unit’s settings (for example, alarms, lead, pacing amplitude and rate) should be re-verified. Charging and Testing Battery Packs ZOLL batteries are designed to be charged in the device or other accessory chargers designed for use with ZOLL devices (XL battery packs also require M Series software version 30.0 or higher).
Battery Management Figure 1 illustrates the effect of lowered battery capacity on the Monitor/ Defibrillator operating time remaining after “LOW BATTERY” warning. Figure 1 Run Time Time before LOW BATTERY warning Low Battery Low Battery Time before shut off New Battery Pack Low Battery Low Battery Low Battery Low Battery Battery Pack That Passes Test Low Battery Battery Pack That Fails Test Age of Battery Pack • DO test battery packs regularly.
M SERIES OPERATOR ’S GUIDE DON’T remove a partially charged battery pack from the battery charger. If a partially charged battery pack is used, a full charge is recommended before its next use. Repeated use after partial charging will quickly diminish the battery’s capacity, thereby shortening its life. DON’T store battery packs in a discharged state. Battery pack capacity will diminish if left in a discharged state for extended periods.
APPENDIX A SPECIFICATIONS General Size 6.8 in. high X 10.3 in. wide X 8.2 in. deep 17.3 cm high X 26.2 cm wide X 20.8 cm -deep Weight 11.5 lbs (5.23 kg) with Multi-Function Cable and battery; 13.5 lbs (6.14 kg) with paddles Power Sealed lead acid battery pack; 5 cells, 2V/cell (wired in series) AC Power 100-120 ~ 50/60 Hz, 220-240 ~ 50 Hz, 220 VA DC Input (Optional) 10-29 V. 130 W Device Classification Class I and internally powered per IEC 601-1. Class II and internally powered per IE 601-1.
M SERIES OPERATOR ’S GUIDE Pacemaker (Pacer Version Only) Type VVI demand; asynchronous (fixed rate) when used without ECG leads or in ASYNC pacing mode. Pulse Type Rectilinear, constant current. Pulse Shape and Duration Rectilinear, 40 milliseconds ±2 milliseconds Pulse Amplitude Variable 0 mA to 140 mA ±5% or 5 mA, whichever is greater. Digitally displayed on the monitor (increments or decrements by a value of 2 mA). Pacing Rate Variable from 30 ppm to 180 ppm ±1.
ECG Monitoring Patient Connection 3-lead ECG cable, 5-lead ECG cable, paddles or MFE Pads. Selectable by front panel switch. Input Protection Fully defibrillator protected. Special circuit prevents distortion of ECG by pacer pulse. (Pacer version only). Implanted Pacemaker Spike Display Dedicated circuitry detects most implanted pacemaker spikes and provides standard display marker of spike on ECG trace. Bandwidth 0.5 Hz - 21 Hz (-3 dB) standard/0.05 Hz - 150 Hz Diagnostic 0.
M SERIES OPERATOR ’S GUIDE Recorder Paper 80 mm thermal (grid width) 90 mm (paper width) Speed 25 mm/sec Delay 6 seconds Annotations Time, date, defib energy, heat rate, pacer output (Pacer version only), QRS sync marker, ECG size, lead, alarm, defib test OK/Fail, analyze ECG, Pads off, analysis halted, noisy ECG, shock advised, no shock advised, ECG too large, and diagnostic bandwidth. Printing Method High resolution, thermal array printhead.
Guidance and Manufacturer’s Declaration — Electromagnetic Emissions The M Series is intended for use in the electromagnetic environment specified below. The customer or user of the M Series should ensure that it is used in such an environment. Emissions test Compliance Electromagnetic environment – guidance RF Emissions CISPR 11 Group 1 The M Series uses RF energy for its internal function only.
M SERIES OPERATOR ’S GUIDE Electromagnetic Immunity Declaration (EID) Guidance and manufacturer’s declaration — electromagnetic immunity for the M Series. The M Series is intended for use in the electromagnetic environment specified below. The customer or user of the M Series should ensure that it is used in such an environment.
EID for Life-Support Functions Guidance and manufacturer’s declaration – electromagnetic immunity – for life-supporting equipment and systems. The life-support functionsa of the M Series are intended for use in the electromagnetic environment specified below. The customer or user of the M Series should ensure that it is used in such an environment.
M SERIES OPERATOR ’S GUIDE Recommended Separation Distances from RF Equipment for the M Series Life-Support Functions Recommended separation distances between portable and mobile RF communications equipment and the M Series. The life-support functionsa of the M Series are intended for use in the electromagnetic environment in which radiated RF disturbances are controlled.
EID for Non–Life-Support Functions Guidance and manufacturer’s declaration – electromagnetic immunity – for non–life-supporting equipment and systems. The non–life-support functionsa of the M Series are intended for use in the electromagnetic environment specified below. The customer or user of the M Series should ensure that it is used in such an environment.
M SERIES OPERATOR ’S GUIDE Recommended Separation Distances from RF Equipment for the M Series Non– Life-Support Functions Recommended separation distances between portable and mobile RF communications equipment and the M Series. The non–life-support functionsa of the M Series are intended for use in the electromagnetic environment in which radiated RF disturbances are controlled.
APPENDIX B TROUBLESHOOTING GUIDES The troubleshooting guides provided on the following pages are intended for use by non-technical medical personnel during device operation. This section answers many of the common problems or questions that may arise during operation. If trouble persists after consulting this guide, contact the appropriate technical personnel or ZOLL Technical Service Department. A more detailed troubleshooting guide is found in the M Series Service Manual.
M SERIES OPERATOR ’S GUIDE Symptom Recommended Action 5. “POOR LEAD CONTACT” message. • Check that ECG cable is connected to patient and instrument. • Check that ECG electrodes are making good contact and not dried out. • If changing from five (5) lead ECG patient cable to three (3) lead ECG patient cable, turn unit OFF for at least 10 seconds. • Replace ECG cable. 6. Noisy ECG, Artifact, Wandering Baseline.
Troubleshooting Guides Recorder Symptom Recommended Action 11. “CHECK RECORDER” message. • Recorder out of paper. • Remove paper, check paper type, check recorder for paper • jam, reload paper. Recorder door is open. 12. Recorder makes stuttering sound when activated. • Check recorder for paper jam. 13. Light or poor quality printing. • Ensure correct paper is in use. • Ensure paper is installed grid side against recorder print head. • Recorder print head requires cleaning (trained personnel only).
M SERIES OPERATOR ’S GUIDE Pacer (Pacer Version Only) Symptom Recommended Action 15. “CHECK PADS” message. • Ensure MFE Pads are connected to Multi-Function cable. • Ensure electrode gel is not dry. Replace MFE Pads if necessary. Ensure good electrode-to-patient contact. • • Check integrity of Multi-Function cable by plugging into test connector. “CHECK PADS” should disappear. 16. No stimulus marker ( trace. ) present on the ECG • Ensure unit is in PACER mode.
Troubleshooting Guides Defibrillator Symptom Recommended Action 21. Excessive artifact when using paddles as ECG source. • • • • • • • 22. Defibrillator will not charge (energy level does not increment on display). 24. Energy does not discharge when the SHOCK button(s) is pressed. Firmly press paddles against patient skin. Use gel on paddles. Clean paddle surface. Check and clean between adult and pediatric shoe. Check cable for damage. Use ECG electrodes.
M SERIES OPERATOR ’S GUIDE Symptom Recommended Action 27. “CHECK PADS” message. • Verify proper Multi-Function Cable / MFE Pad connection by • • • 28. “USE PADS” message. disconnecting and reconnecting the Mult-Function cable and MFE Pads. Ensure proper contact of Multi-Function Pads and that the patient does not have excessive hair beneath the electrodes. If message persists, disconnect Multi-Function cable from MFE Pads and plug cable into test connector.
Troubleshooting Guides Symptom Recommended Action 34. “LOW BATTERY” message appears on monitor when unit is plugged into AC mains. • Replace battery pack with a fully charged battery pack. • Unplug device from AC mains and plug device back into AC mains. • Verify AC mains is working properly. 35. None of the CHARGER ON indicators are illuminated when the device is plugged into AC mains. • Unplug device from AC mains and plug device back into AC mains. • Verify AC mains is working properly.
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APPENDIX C MEDICAL REPORT CAPABILITY The unit's medical report capability automatically records incident information for subsequent review and archiving. Data is stored on a removable PCMCIA type II data card (memory card) for uploading to a properly equipped personal computer. The medical report capability begins recording when the unit is turned on and continues until the unit is turned off. Patient ECG, unit status, date, time and control settings are recorded.
M SERIES OPERATOR ’S GUIDE Warning Messages The correct communications settings are: If configured, the following messages are displayed to prompt the user to check the PCMCIA card. Bits per second* 115 200 bps (default) You can also use 9600 bps or 38 400 bps CARD FULL The PCMCIA Data Card is full. No more data will be stored on the card but the unit will continue to operate. This prompt is only given when the unit is not analyzing or charging.
4. Activate the communication software on the receiving PC. If not done already, prepare the host system (PC) to receive a data file by entering the communications settings as shown on the previous page. 5. Press the Send softkey. Uploading begins in about one second. The Upload screen displays a progress bar that indicates the percentage of data transferred to the PC. To stop data transmission, move the unit's rotary switch to OFF.
M SERIES OPERATOR ’S GUIDE Display Messages Message Reason/Action Card Removed Card was removed from PCMCIA slot or is not seated properly. Reinsert card. Empty Card Empty data card inserted into PCMCIA slot or card was erased. Record data on card before transmission or insert different card. Not a Data Card Wrong type of card. Insert a data card. Host Fault Transmission was stopped because PC detected an error or user cancelled transmission via the PC communication program.
